Safety and metabolic advantages of steroid withdrawal after 6 months posttransplant in de novo kidney transplantation: A 1-year prospective cohort studyopen access
- Authors
- Bang, Jun B.; Oh, Chang-Kwon; Kim, Yu S.; Kim, Sung H.; Yu, Hee C.; Kim, Chan-Duck; Ju, Man Ki; So, Byung J.; Lee, Sang Ho; Han, Sang Y.; Jung, Cheol W.; Kim, Joong K.; Ahn, Hyung J.; Lee, Su H.; Jeon, Ja Y.
- Issue Date
- 3월-2022
- Publisher
- WILEY
- Keywords
- cholesterol; glucose tolerance test; kidney transplantation; steroids
- Citation
- IMMUNITY INFLAMMATION AND DISEASE, v.10, no.3
- Indexed
- SCIE
SCOPUS
- Journal Title
- IMMUNITY INFLAMMATION AND DISEASE
- Volume
- 10
- Number
- 3
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/142112
- DOI
- 10.1002/iid3.576
- ISSN
- 2050-4527
- Abstract
- Introduction: This prospective multicenter study aimed at investigating the safety and metabolic advantages of steroid withdrawal (SW) therapy in kidney transplant recipients with tacrolimus-mycophenolate mofetil-based immunosuppression. Methods: We analyzed 179 recipients who received kidney transplantation from March 2016 and September 2018. In 179 recipients, 114 patients maintained an immunosuppressive regimen including steroids (steroid continuation [SC] group). The remaining 65 patients were determined to withdraw steroid therapy after 6 months posttransplant (SW group). Metabolic parameters and graft functions of the two groups were evaluated. Results: The estimated glomerular filtration rates at 12 months posttransplant were 67.29 +/- 20.29 ml/min/1.73 m(2) in SC group and 73.72 +/- 17.57 ml/min/1.73 m(2) in SW group (p < .001). The acute rejection occurred to four recipients in the SC group (3.5%) and no acute rejection occurred to SW group recipients during the 6-2 months posttransplant period. Oral glucose tolerance tests revealed that recipients in the SW group were more improved in glucose metabolism than the SC group during 6-12 months posttransplant. In addition, cholesterol levels and blood pressure decreased after the withdrawal of steroids in the SW group. Conclusion: In conclusion, a 6-month withdrawal of steroids in recipients with low immunological risk and stable graft function can be safely conducted and result in improvement of metabolic profiles. Stable recipients without biopsy-proven acute rejection and proteinuria can safely withdraw from steroids out of a maintenance immunosuppressive regimen 6-months posttransplant. A long-term follow-up study is needed to verify our results.
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